Individual provider Active NPI

Marc J Ofchinick

  • Optometrist
  • Colorado Springs, CO
National Provider Identifier
1336693217
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0003229 Issued in CO
Practice address
1130 Lake Plaza Dr
Suite 230
Colorado Springs, CO 80906-3594
Phone
(719) 219-3819
Fax
(719) 219-0411
NPI assigned
Aug 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.0003229 CO Primary

Addresses

Primary practice location

1130 Lake Plaza Dr
Suite 230
Colorado Springs, CO 80906-3594

Mailing address

1130 Lake Plaza Dr
Suite 230
Colorado Springs, CO 80906-3594
Phone (719) 219-3819

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170511001843 CO Practitioner - Optometry 5193002525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14749 W 87TH Pkwy Unit D
Arvada, CO 80005-1337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.0003229COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sowash Optometry Group, PC Optometrist CurrentSince Jan 26, 2020 Accepting new patients
Sowash Optometry Group PC Optometrist CurrentSince Jan 26, 2020 Accepting new patients
Sky High Vision, PLLC Optometrist CurrentSince Nov 16, 2020 Accepting new patients

Locations

14749 W 87th Pkwy
Unit D
Arvada, CO 80005
Phone (720) 673-0555

13955 E Mississippi Ave
Aurora, CO 80012
Phone (303) 695-4999

4206 N Freeway Rd
Pueblo, CO 81008
Phone (719) 253-2538

Interoperability endpoints

  • Direct secure messaging: marc.ofchinick@uprisedirect.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1336693217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 LAKE PLAZA DR",
            "address_2": "SUITE 230",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063594",
            "telephone_number": "719-219-3819",
            "fax_number": "719-219-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 LAKE PLAZA DR",
            "address_2": "SUITE 230",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063594",
            "telephone_number": "719-219-3819",
            "fax_number": "719-219-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFCHINICK",
        "first_name": "MARC",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.